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Parsing the Promise

Mary Landrieu's Obamacare Repair

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Sen. Mary Landrieu

In the struggle to make sure all Americans are properly insured and can receive medical treatment going into the future, a battle has begun over whether certain insurance policies should count as "proper coverage," as the rollout of Affordable Care Act moves forward. Just like when Obamacare was initially passed, Sen. Mary Landrieu is once again near the center of the fray.

Senator Mary Landrieu recently followed through with the pitch she made a couple of weeks ago to work to revoke cancelation notices that went out for policies not meeting the new mandatory minimum for coverage. The Louisiana Democrat's idea is that people having any insurance is more important than seeing their policy be canceled over coverage mandates

"When the Affordable Care Act was passed, a promise was made that if you like your current health care insurance, you could keep it," Sen. Landrieu said on the floor of the Senate recently. "Although most in Louisiana have their health care through an employer, some in the individual market (about 4-percent) have received cancelation notices."

The Pelican State's estimated 93,000 potential cancelations would be saved under the Senator's new legislation, dubbed the "Promise Act." The legislation is aiming to allow many insurance policies that do not meet the latest minimum guidelines for insurance coverage to be grandfathered in.

Landrieu says that this move is meeting a promise (hence the name) initially laid out by the ACA, which is to make sure Americans are insured. So, instead of having these 4-percent of policies canceled and having the individuals shop for "proper" coverage on the new exchanges, the old plans will continue, counting those individuals as insured passed the 2014 deadline for updating coverage. However, the level of insurance becomes the question, and if these people are actually properly insured.

"Well, my bill makes it clear that that was a promise made and that's a promise we're going to keep," said the senator. "It's as simple as that. But let me explain a little bit about if you have insurance you can keep it. 1.8 million people in my state have insurance through their employer. 1.5 [million] have it through public programs, Medicare or Medicaid. And less than 4-percent have it through the individual market. That individual market was broken. People were getting dropped all the time, rates were getting raised, and the policies offered weren't even that great."

These points were reiterated when we contacted Landrieu's staff, who said that the exchanges are still viable options, but if any person wants to continue using their insurance coverage, that should be allowed.

"It is a very plausible expectation that people very well could buy or could find better coverage, at a better value, on the market places," said a Landrieu staffer. "But, it is just straight forward. the President has said time and time again that, 'if you like the coverage, you can keep it.'"

Even though her office cites the President's prior commitment, Landrieu's position seems to butt heads with the Obama administration's idea that everyone be insured to a certain standard. Landrieu has said that the size of the group concerned is such a small percentage that it should not undermine the work already done. Rather, she wants to provide an out for this group to keep their policies.

"Well, if it was a much larger number, it might cause [the health care changes] to not work," Landrieu said in an interview with NPR. "But this is a small enough number that I think the concepts of this will still stay intact."

Her staff also pointed out that because of the rate of policy turnover in the individual market, it is likely people will end up changing their policies anyway.

The important thing, Landrieu's office said, is that this particular legislation allows people to keep their plans if they want, but still allows the ACA to move forward.

"The Senator's bill doesn't allow new people on to these old plans, first point. The second point is that it would allow people who have these plans to keep them as long as that want—so long as they don't miss a payment or change the plan," the Landrieu staffer said.

Sen. Landrieu has also been clear that she will make sure insurance providers are required to tell policy holders what they're missing out on if they continue to hold these grandfathered policies.

"My bill will also provide policyholders information from their insurance company on which parts of their policy do not meet minimum coverage standards made available in new plans, such as hospitalization, laboratory services and prenatal care," Landrieu said. "Consumers should know what is covered and what is not covered, and still have the option to keep their current plan."

Landrieu isn't the only rep on Capitol Hill offering amendments to Obamacare. Other bills either establish sunset dates on this grandfathering of plans. Others remove provisions letting young adults stay on their parents' plan until age 26, or take away certain consumer protections regarding policy conflicts or mistakes that would compromise coverage, according to Landrieu's staff.

These aforementioned sunset dates could be construed as a way of making sure people eventually move to the right coverage plans. However, "at the same time, I don't know if that is keeping the promise."

Dividing lines?

While Landrieu's policy intentions seem clear, the water seems to muddy once the surrounding politics is brouight into the equation.

It is important to note that the Senator was also called out this week for distancing herself from the President on his recent New Orleans trip. Some are even saying this bill is a mere attempt to separate herself from the health care bill and the administration as Landrieu moves closer to her 2014 re-election in a state where Obamacare is unpopular.

As for Landrieu seemingly adversarial position to the administration in this bill, this is what one of her staffers had to say:

"Some people are saying, 'this is Landrieu trying to run away from the healthcare bill.' The Senator's been very clear about her support for the healthcare bill, but she has also been very clear that any piece of legislation is going to have its problems, and as things arise, 'I want to fix it and make it stronger.'"

According to her staff, the Senator realizes the hope for the ACA is too great to chance, and that is why she is proposing, "the targeted, smart fix," versus the bills that may have the intent of tearing down or defunding the healthcare bill.

"Those who make that charge [about Landrieu] seem more interested playing politics themselves than fixing and strengthening the bill to make it work as intended," the staffer concluded. "The House bill (offered by Rep. Fred Upton, Republican of Michigan) is only a one-year patch (You can keep your plan—for one more year) and (Wisconsin GOP) Sen. (Ron) Johnson's bill would allow insurers to rescind coverage, kick young adults off their parents plans and reinstate lifetime caps. Sen. Landrieu's bill is the only target and smart fix in Congress right now."